带有胚系BRCA1/2突变的激素受体阳性HER2阴性转移性乳腺癌的一线治疗功效。
Efficacy of front-line treatment for hormone receptor-positive HER2-negative metastatic breast cancer with germline BRCA1/2 mutation.
发表日期：2023 Apr 03
作者：
J-S Frenel, A Lusque, S Delaloge, J-M Ferrero, T Bachelot, I Desmoulins, C Levy, J-C Eymard, A Gonçalves, A Patsouris, M A Mouret Reynier, M J-C Thery, T Petit, L Cabel, L Uwer, M Debled, M Chevrot, A Mailliez, W Jacot, T de La Motte Rouge
来源：
BRITISH JOURNAL OF CANCER
摘要：
内分泌疗法在HR+/HER2-转移性乳腺癌中的疗效可能因BRCA1/2生殖系突变的存在而有所差异。ESME转移性乳腺癌平台（NCT03275311）是法国的真实世界数据库。多变量模型包括时间可变方法和里程碑分析评估了时间相关的gBRCA状态（分类为gBRCAm，gBRCAwt（野生型）和未经检测）与总体生存（OS）和一线无进展生存期（PFS1）之间的关联。共有170名患者为gBRCAm携带者，676名为gBRCAwt，而12,930名未经过基线检测。在多变量分析中，与gBRCAwt相比，gBRCAm携带者的OS总体较低（调整后HR [95％ CI] 1.26 [1.03-1.55]）。接受一线内分泌治疗的gBRCAm患者的调整后OS（调整后HR [95％ CI] = 1.54 [1.03-2.32]）和PFS1（调整后HR [95％ CI] 1.58 [1.17-2.12]）均低于gBRCAwt患者。然而，对于接受一线化疗的患者，gBRCAm携带者和其他组之间的OS和PFS1并没有差异（与gBRCAwt相比的OS的HR：1.12 [0.88-1.41]，p = 0.350; PFS1：1.09 [0.90-1.31]，p = 0.379）。在这个大型HR+/HER2- MBC患者队列中，gBRCAm状态与一线内分泌治疗后较低的OS和较低的PFS相关，但在一线化疗后并不相关。©2023年。作者（S）独家许可Springer Nature Limited。
Efficacy of endocrine therapy in HR+/HER2- metastatic breast cancer could differ depending on the presence of BRCA1/2 germline mutation.The ESME metastatic breast cancer platform (NCT03275311) is a French real world database. Multivariable models including a time-varying approach and landmark analyses assessed the association between time-dependent gBRCA status (categorised as gBRCAm, gBRCAwt (wild type), and untested), overall survival (OS), and first-line progression-free survival (PFS1).A total of 170 patients were gBRCAm carriers, 676 gBRCAwt, and 12,930 were untested at baseline. In the multivariable analysis, gBRCAm carriers overall had a lower OS compared to gBRCAwt (adjusted HR [95% CI] 1.26 [1.03-1.55]). gBRCAm patients treated with front-line endocrine therapy had lower adjusted OS (adjusted HR [95% CI] = 1.54 [1.03-2.32]) and PFS1 (adjusted HR [95% CI] 1.58 [1.17-2.12]) compared to gBRCAwt patients. However, for patients who received frontline chemotherapy, neither OS nor PFS1 differed between gBRCAm carriers and the other groups (HR versus gBRCAwt for OS: 1.12 [0.88-1.41], p = 0.350; PFS1: 1.09 [0.90-1.31], p = 0.379).In this large cohort of HR+/HER2- MBC patients treated in a pre-CDK4/6 inhibitors era, gBRCAm status was associated with a lower OS and lower PFS following first-line endocrine therapy, but not following first-line chemotherapy.© 2023. The Author(s), under exclusive licence to Springer Nature Limited.